Detecting Foot Ulcers Before They Cause Big Trouble

One good thing about foot ulcers is their early warning system. When a foot ulcer is developing, it may not be obvious even to a doctor, but it will likely be a warmer spot on your foot.

To take advantage of this warning, a new medical system uses temperature data to predict that an ulcer will develop more than a month before it surfaces. With this system, doctors would have more time to treat it.

“The best way to prevent neuropathy is to keep blood glucose levels as close to the normal range as possible,” the U.S. National Institute of Diabetes and Digestive and Kidney Diseases states. “Maintaining safe blood glucose levels protects nerves throughout the body.”

Still, if you or your doctor detects an ulcer early enough, you can avoid this tragedy. Fortunately, I was able to listen to a study telling how this new system works when I went to this year’s annual convention of the American Diabetes Association in New Orleans. This is the world's largest scientific meeting focused on diabetes, and I represented HealthCentral.com.

Doctor of Podiatric Medicine Robert G. Frykberg presented the study, “An Automated Home Monitor for the Early Detection of Diabetic Foot Ulcers.” Dr. Frykberg is the director of podiatric medical education at the Veterans Affairs Medical Center in Phoenix and a professor at the University of Arizona College of Medicine. His unpublished study, 141-OR, investigated whether heat-sensing mats used at home could help detect foot ulcers earlier, and therefore help prevent them.

A study of people at high risk

Dr. Frykberg was the principal investigator of this prospective, multicenter cohort study that followed 129 high-risk people for 34 weeks. Those at a highest risk of developing a foot ulcer are people who already had one, he says. The study included only those people with diabetes who had a healed ulcer or an amputation of the foot.

During the study, 37 of the subjects developed a total of 53 ulcers. The study showed that using the mat could predict the development of 97 percent of the ulcers about five weeks ahead of time.

Using the device is simple

“People who use it have nothing to do except keep it turned on and step on it each morning,” Dr. Frykberg says. This takes a thermogram of their feet and sends off the data to a central server. A difference of four or more degrees Fahrenheit on two successive days will register an alert, which is then transmitted to the user and to his or her doctor for necessary treatment.

A start-up company, Podimetrics in Somerville, Massachusetts, makes the device and manages the system. Its Remote Temperature Monitoring System includes the Podimetrics Mat.

It is “a wireless, in-home monitoring technology that collects foot temperature scans,” the company says. “Step on it for twenty seconds a day, and we’ll take care of the rest.”

Podimetrics has just begun to sell the system. Jonathan Bloom, MD, told me in a telephone interview. He is the company’s CEO and co-founder as well as one of the inventors of the system.

“We are providing the system to the VA in particular,” Dr. Bloom says. “It is such an important population for us.” Dr. Frykberg also told me that the VA Medical Center where he works has begun to use it.

The Podimetrics device requires a prescription, so if you have a history of foot ulcers, you may want to ask your primary care physician or podiatrist about it. But don’t be surprised if your doctor isn’t aware of it yet.

Potential game changer

When I asked my local podiatrist, John Jachimiak, DPM, at Boulder County Foot and Ankle, what he thought of it, he replied:

“I have not seen this technology, but the concept is awesome. It could be a game changer for people with diabetes.”

David Mendosa is a journalist who learned in 1994 that he has Type 2 diabetes, which he now writes about exclusively. He has written thousands of diabetes articles, two books about it, createdone of the first diabetes websites, and publishes the monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, current A1C level of 5.7, and BMI of 19.8 keeps his diabetes inremissionwithout any drugs.